JAMA Cardiol

Salt substitutes reduce risk of recurrent stroke, death

February 10, 2025

Salt substitution is a safe and effective intervention for reducing the risk of recurrent stroke and death in patients with a history of stroke. Scaling up this low-cost intervention has the potential for large health gains, particularly in populations with high stroke prevalence.

Study details: The Salt Substitute and Stroke Study (SSaSS; NCT020920090) trial involved 15,249 patients with a history of stroke. Participants were randomly assigned to either an intervention group receiving a salt substitute (75% sodium chloride, 25% potassium chloride) or a control group using regular salt.

Results: Over a median follow-up of 61.2 months, the salt substitute group experienced a 14% reduction in risk of recurrent stroke (rate ratio [RR], 0.86; 95% confidence interval [CI], 0.77-0.95; P=0.005) and a 12% reduction in risk of death (RR, 0.88; 95% CI, 0.82-0.96; P=0.003). The reduction in stroke was more pronounced for hemorrhagic stroke (relative reduction, 30%; P=0.002). There wasn’t a significant difference in the incidence of hyperkalemia between the groups (RR, 1.01; 95% CI, 0.74-1.38; P=0.96).

Source:

Ding X, et al. (2025, February 5). JAMA Cardiol. Salt Substitution and Recurrent Stroke and Death: A Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/39908026/